Abstract

This study evaluated selected psychosocial outcome measures of Attention Deficit Hyperactivity Disorder(ADHD) in adolescence. Forty-eight males and females meeting Research Diagnostic Criteria for ADD and 37 clinical control children were followed prospectively over a 5-10 year period into mid-adolescence. Using questionnaire data obtained from both parents and adolescents, as well as ratings from schools, group outcome was measured in terms of academic achievement, internalizing and externalizing behavior, self-esteem, adaptive functioning, substance use and psychopathology.^ It was hypothesized that the Attention Deficit Disorder (ADD) group would have a poorer overall outcome in adolescence. It was further hypothesized that ADD adolescents who met criteria for a conduct disorder would form a subgroup (ADD/CD) and that a significant difference would emerge between this group and the group of ADD adolescents without conduct disorder. Multivariate analyses were employed to assess the overall outcome in terms of psychosocial adjustment and followed up by univariate tests. To address whether former ADD children (DSMIII) who do not meet current diagnostic criteria for ADHD (DSMIII-R) continue to exhibit more maladaptive behaviors than clinical controls, a multivariate analysis was performed.^ Results of this study indicate that when compared with a group of clinically referred children, rather than a group of normal controls, ADD children have a poorer outcome in adolescence, and ADD children who develop conduct disorder fare more poorly than ADD children who do not meet criteria for conduct disorder. Specifically, results suggest that for the outcome measures--academic achievement, socialization skills and behavior--ADD adolescents function significantly worse and have more symptoms of psychopathology than matched clinical controls except for conduct disturbance. The ADD youths rated themselves similarly to controls on measures of self-esteem, daily living skills and amount of substance use. Both groups had poor communication skills. A subgroup of ADD/CD adolescents had more externalizing behaviors and impairment in daily living skills when compared to the group of ADD adolescents without conduct disorder. The additive combination of the diagnosis of conduct disorder places the ADD youngster at greater risk for a poor outcome. ^